Surgical treatment of tailgut cysts: a single-center analysis of 19 cases

Purpose Tailgut cysts are rare benign lesions with inflammatory and malignant potential. However, studies evaluating treatment outcomes in larger patient cohorts remain very limited. This study presents our institutional experience with tailgut cyst management, outlining diagnostic and therapeutic challenges and key insights gained. Methods Retrospective, descriptive single-center study, including patients with tailgut cysts surgically treated from 2014 to 2025. Results This study included 19 patients (female, 78.9%; median age, 35 years). The most frequent symptoms was lower back pain (36.8%). Meanwhile, 21% of the patients were asymptomatic. All patients underwent magnetic resonance imaging, with 78.9% suspected with a tailgut cyst or benign cystic lesion preoperatively. The mean cyst diameter was 5.8 ± 3.07 cm, and 36.8% of the patients had a multilobular morphology. Posterior (Kraske) approach was used in 78.9% of patients. One patient underwent laparoscopic cyst resection, and three required rectal resection. Posterior approach associated with minimal blood loss, lower complication rates and shorter length of stay. Regarding postoperative complication, wound infections was the most common (10.6%). Three (15,8%) patients experienced recurrence. The median follow-up period was 37 months. Conclusion This study presents one of the largest single-center cohorts of resected tailgut cysts. Magnetic resonance imaging is typically sufficient for diagnosis. Multilobular cysts are associated with recurrence, often pose diagnostic challenges, and may lead to unnecessarily extensive surgical intervention, which is associated with an increased risk of complications. The dorsal approach combined with secondary wound healing proved safe and effective, yielding high patient satisfaction and low complication rates.